Tuesday, February 21, 2012

ALCOHOL

Alcohol abuse, its effects on society as well as habitual
drinkers, has become a major topic of discussion in the British Society, even
as the opinion-makers struggle to find ways to cope with systematic abuse and
binge drinking.

TIME
FOR A NEW APPROACH TO ALCOHOL

NICK
EDWARDS

As an Accident and Emergency doctor, I see at first
hand the effects that our booze culture is having on our health. And it scares
me: self-induced illness costing the NHS a fortune, putting millions of
patient’s health at risk ….. and taking my time away from looking after other
patients. Some days I just despair. Last week was one of them.

In the same shift three teenagers were brought in
before 9 pm dangerously drunk – the all drank vast quantities
of beeer/wine/vodka/odd-coloured – surgery-alcohol-pop, before going out and
then collapsed at various places outside the clubs they were on route to.

Ambulances were called and they were brought to my
care. One was so drunk we had to suction out the vomit from her mouth to stop
her choking to death. Another girl wet herself and then proceeded to vomit on
the floor and hurl abuse at the staff. The third was so unconscious we ended up
having to take over their breathing and taking them for a CT scan of their head
to check that they hadn’t had a head injury. Why on why does this happen so
regularly?

Alcohol induced fights

Later on that evening there had been a
punch up outside a night club – alcohol induced. Involved were two patients.
Injuries were one facial bone fracture, one neck laceration from biting, two
broken hands and a ruptured liver from being kicked in the stomach.

Between them, the patients had a total of
four operations, over 10 days in hospital- four of which were in intensive care
and had a total of three A&E doctors, six surgeons, four anesthetists, six intensive
care doctors, seventeen nurses, twelve operating department practitioners,
three physiotherapists, three pharmacists and an occupational therapist
involved in their care. It becomes obvious why alcohol is so expensive for the
NHS.ass

But it is not just your typical binge
drinker tha causes problems. Last week a 68 year old retired solicitor came in.
His partner had called an ambulance after he fell down the stairs. He had had
his usual daily alcohol; four pints of Stella and a couple’ of whisky chasers
not to mention a ‘few’ glasses of claret. He fractured his neck and skull and
nearly died from internal bleeding. He had to put him to sleep, take him for an
emergency scan and then to theatre and then to intensive care. He will survive
but it is unlikely he will walk again. His care will be reassuring expensive
for the tax payer.

Chronic alcohol use

Then there are the effects of chronic alcohol use. A 45 year old man
came in as he felt so terrible – so terrible that he had n’t been able to drink
for two days – a very worrying sign. He had been drinking dialy since he had
married. He a drank a bottle of wine with his meal each night and then before
bed, a glass or two of whisky. He worked as an office manager, had two children
and was very typical friendly next door neighbour.

But he had given himself alcoholic
hepatitis. His liver couldn’t cope any more with this level of alcohol and had
gone into “shut-down”. Unless he stops drinking it won’t be long before this is
a permanent state, liver cirrhosis develops and then he could become another
sad statistic.

Sometimes at work, you just despair
and wonder why it is happening. Of all the drugs there are alcohol is the most
dangerous – in the short term and long term. It is also the drug which cuases
the most problems and costs the most for the NHS.

Drinking
glamourised

But all that has
happened in the last few years is binge drinking has been glamourised and
alcohol has been become easier to get and cheaper.

So, what can society do? We need to
de-glambourise alcohol – celebrities have a role to play as we know the
influence they have. But we all need to be more responsible : teaching our
children sensible limits and drinking responsibility ourselves. How many people
reading think it is ok to drink a bottle of wine at night? As my patient showed it is dangerous and you
need to cut-down. Learn how much is safe to drink and stick to it otherwise you
could end up in a similar state.

But the government needs to act. Self regulation of the alcohol
industry has failed. We need a coordinate approach, which doesn’t damage the
pub trade or affect the millions of people who sensibly enjoy a few pints a
week.

The health of our populations is more important than the share prices of
a few drinks companies and supermarket.

Here is my manifesto:

We
need a minimum alcohol price; supermarkets should be banned from selling
crazily cheap alcohol. Not only would it cut alcohol consumption, but would
help pubs as people will be less inclined to drink at home.

Change Culture

We should encourage European style café culture and not a let’s get as
drunk as possible as quickly as possible. Pubs should be forced to have
adequate seats and tables and not be “vertical drinking” establishment.
Redesigning of pubs has been shown to cut down massively on excess drinking.
24-hour drinking has not really increased alcohol drinking in A&E, it has
spread it out throughout the night. I would be happy for 24 hour drinking to
continue if real changes were made to drinking culture.

Curb Promotions

Promotions which encourage excess drinking should be banned – drink as
much as you can for a tenner, buy one get one free shots etc.

We should have a tax which is reflective on how strong the alcohol is
and how likely it is to be drunk by underage teenagers. Overall tax should be
increased on alcohol as this has shown an overall decrease in demand. It may
not be popular but a few extra pence a week for the majority of sensible
drinkers would save thousand of precious lives a year.

Clubs and pubs should be fined much more if they sell under age people
and drunken people. The extra taxes should be hypothecated and not enter into
general taxation pot. They should pay for alcohol withdrawal programmes and
extra A&E staff for evenings when the consequence of alcohol hit us.

Don’t glamourise drinking

Finally, adverts glamourising alcohol should be banned and there should
be explicit labels how much alcohol there is in drinks shown on the front of
drinks.

If any from drink industry does not
believe me, then please join me on Saturday night in A & E. You will go
home in despair, as I do most nights and
you will be persuaded that something needs to be done.

The write is a
doctor who wrote the book “ In stitches, the highs and lows of life as an A
& E doctor.” --- The Independent.